Parliamentary Secretary for Health Dr Joe Cassar has been reported by The Times as saying that 70% of patients who go the Accident and Emergency department “without a referral could have been treated by the family doctor”.
He also enlightens us on the fact that government intends to “review regulation of free medicines”. The report makes the shocking verifiable truth that last year, the Breast and Cancer Association said there were women who had to take out loans to pay for their drugs.
Then the Parliamentary Secretary declares that Mater Dei “has enough bed capacity” and “the hospital must be used for the purpose it was designed”.
I was not surprised at all by the politician’s declarations. Like many other mortals on this island, I had the misfortune of utilising the general hospital. I never questioned the doctors’ capabilities or the staff dedication. In general, the hospital service is satisfactory and any biased criticism for criticism’s sake can do more harm than good to the smooth administration of the hospital. However, we would be fooling ourselves if we thought that because Mater Dei is a new hospital, everything must be running perfectly well and there should be no constructive and objective criticism. I still believe that the new hospital should have been managed by a new, modern and professional management team set up to depart from the old ways of St Luke’s Hospital.
The mistakes at St Luke’s are being repeating at Mater Dei simply because there are managerial problems. The fact that 70% of patients make use of the Emergency Department instead of utilising polyclinics is simply a declaration that we need to regenerate the medical service in the community which was unwittingly downsized by government. It does not make sense that an entire population flocks to just one place (Mater Dei) even for the most minor cases when the service could be provided more efficiently by different outlets spread all over the island. During the past years local and district facilities were trimmed, leaving just one choice: St Luke’s, and now Mater Dei. While administrators are feeling the burden, the public is suffering undeservedly. Why should a person have to wait for six to eight hours at the Emergency and Accident Department of Mater Dei when he/she could receive the same service in his/her locality or district in a few minutes?
Realism dictates that a system that has been dismantled must take some time to re-invent. The first problem that has to be addressed is one of human resources. Lack of job satisfaction and poor remuneration of housemen and other junior medical practitioners at Mater Dei and polyclinics are not rendering the service any better. I am not suggesting that other senior grades are living in heaven. However, statistics show that personnel from the junior grades are fast leaving the island to find greener pastures elsewhere. The majority of new doctors are leaving making it more difficult for polyclinics to be properly manned.
Perhaps it is also high time for the University to consider easing grades for new entrants to the course of medicine. Why should students aspiring to become doctors meet an indirect and subtle numerus clausus? Why should a student failing to obtain a B grade be refused? In my opinion a person who obtained a C in his A-levels may be as good a doctor as a B student. Apart from academic qualifications there are other attributes that can make a student a first-rate professional. Dedication, concern for the patient, and considering the profession as a mission are qualities that should not be overlooked in the caring profession.
On the question of free drugs there is much to be said. The first hitch is the ignorance surrounding the whole concept. The Health Department should embark on a long and persistent educational programme to make the public aware that free medicines should be carefully applied for and used. Patients would always find doctors who are ready with prescriptions but it would be a gross mistake to economise on free drugs and risk the lives of people for a healthier balance of the budget. This does not mean that wastage should not be curtailed. The most effective way is to educate and instil a sense of civic duty among those making use of the service. People should be made aware that if they take a drug unnecessarily they could risk the health of their friends, neighbours and even members of their own family who might need the drug and not find it.
When it comes to the deletion of certain drugs from the present list one has to be very careful. Those who are entitled to a particular drug do not take it for fun. They need it in the first place. So how can one justify the elimination of certain drugs? What are the criteria to be applied to discriminate between certain drugs and others?
The solution is not to shorten the list of free medicines but to work hard and convince people that they should only apply for medicines they badly need. Recently, a scientific research showed that artificial vitamins do more harm than good; this is one area where people should be encouraged to eat healthier food rather than depend on artificial supplements.
Since we are dealing with the well-being of people, any reform should be carefully studied so as not to jeopardise the basic fundamental human right: the right to life.
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